[Treatment of benign prostatic hyperplasia by radiofrequency (TUNA): a monocentric study of 28 cases treated in ambulatory surgery]. / Traitement de l'hypertrophie bénigne de prostate par radiofréquence (TUNA) : étude monocentrique à propos de 28 cas traités en chirurgie ambulatoire.

AIM: To assess the feasibility of ambulatory surgery in the treatment of benign prostatic hyperplasia using radio frequency (TUNA) and evaluate its place in terms of efficiency among other minimally invasive surgical techniques. METHOD: Fifty-four patients suffering from benign prostatic hyperplasia and for whom medical treatment was ineffective, were treated with radio frequency between September 2004 and June 2007. Among them, 28 patients, whose average age was 65.8 (aged 52-82), were selected for Transurethral Needle Ablation (TUNA) as outpatients. Urine status was assessed before and after TUNA treatment using the International Prostate Score System, the Quality Of Life-score to urinary symptoms, the measures of the maximal flow rate and of the residual urine. The erectile function was assessed using the five-item version of the International Index of Erectile Function (IIEF-5). RESULTS: With an average regression of 12.14 months, a significant improvement in urine status was observed with an average IPSS score passing from 22.4 to 9.75 and an average quality of life score passing from 4.9 to 1.9. The maximum flow rate and average flow volume increased significantly from 8.66 to 14.6 ml/s and from 202 to 248.4 ml respectively. Average urine residue was reduced from 177.4 to 112.2 ml (p<0.05). The IIEF-5 score did not increase significantly (14.1 versus 12.8). There were no cases of patients being rehospitalised. One case of prostatitis and six cases of acute urinary retention were observed at the postoperative stage. The rate of retreat was 21.4%. CONCLUSION: TUNA treatment is a minimally invasive technique of benign prostatic hyperplasia which can be carried out in ambulatory surgery and which is effective for urinary symptoms with little risk of morbidity. It is an alternative to medical treatment and does not replace planned surgical treatment.

[Mycotic aneurysm and renal transplant. A case report]. / Anévrisme mycotique et transplantation rénale. A propos d'un cas.

The arterial aneurysm secondary to Candida is a rare but frightening complication of renal transplant. We report the case of a 58-year-old patient who developed an arterial aneurysm secondary to a Candida infection in 3 weeks of a third renal transplant. Candida albicans was isolated from the preservation solution. The treatment consisted of a transplant nephrectomy, aneurysm excision and an iliac bypass with cryopreserved iliac homograft. All of bacteriologic culture was positive for Candida. The positive bacteriologic culture for Candida in preservation solution requires antifongic treatment. In case of arterial aneurysm, a surgical treatment is necessary but majority of kidney transplant had to be removed.

[Ureteral obstruction from endometriosis: a case report and review of the literature]. / Obstruction urétérale d'origine endométriosique: à propos d'un cas et revue de la littérature.

Endometriosis frequently affects women with genital activity and exceptionally involves the urinary tract, and the ureter in particular. From a case report of a female consulting for renal colic pain related to an intrinsic-type pelvic ureteral endometriosis, we report the difficulty in diagnosing this pseudotumoral obstruction and finding therapeutic options with a review of the literature. Ureteral endometriosis is marked by non-specific symptoms liable to delay preoperative diagnosis with a risk of deterioration of renal function due to the obstruction. Regarding the therapeutic approach, the surgical treatment associated or not with GNRH agonists seems best.